Bilateral Parapharyngeal Abscess Complicated with Trismus, Airway Obstruction and Bleeding

Abstract

Bilateral parapharyngeal abscess is a very rare condition. Placing pressure on the airway on both sides increases the risk of respiratory arrest. Intubation cannot be performed due to the trismus caused by the infection in the mastication muscles, and the need to create an emergency airway can only be provided by invasive means. The adjacency of the region to major vessels and their branches can lead to massive hemorrhages since the infection erodes the vascular wall. In a case of bilateral parapharyngeal abscesses which resulted in respiratory arrest due to the trismus, we were able to ensure airway safety using a coniotomy and subsequent tracheotomy. The presence of massive hemorrhages on both sides in the early postoperative period caused us to remain constantly vigilant until the full recovery of the patient in terms of clinical, laboratory and radiological parameters.

Keywords

• Bilateral
• parapharyngeal
• abscess
• airway
• bleeding

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